The present disclosure relates generally to spinal orthoses, and more particularly, to a mechanically advantaged spinal system, which may be a progressive spinal system. Spinal orthoses are frequently prescribed and worn to limit body motion, to reduce body-realized load, and/or to improve body function, essentially according to accomplishment of the same purpose: 1) compression of the abdomen, 2) limitation of spinal motion, and 3) protection of the torso. Indications of use may include, without limitation, osteoporosis, spondylolysis, burst fracture, spinal stenosis, spondylolisthesis, chronic back pain, degenerative disc disease, herniated or bulging disc, ligament strain/sprain, compression fracture, spinal stabilization, post-laminectomy, or the like. Irrespective of the indication, however, orthosis design necessarily dictates functionality and overall performance.
Typically, orthosis attributes and features are selectively balanced according to the needs of a particular patient, wherein consideration may be given to such features as the overall weight and adjustability of the orthosis, including its ability to accommodate patient size variation, the ease of donning (putting on) and doffing (taking off), the overall functionality and cosmesis (desirable physical appearance), and, as with essentially any medical tool or device, durability of materials and cost. Unfortunately, in spinal bracing, one benefit or attribute must typically be traded to get another, e.g. comfort versus support, rigid control versus softness, and/or custom-like fit versus simplicity.
Functionality and performance are obviously critical considerations; however, the patient must be able to properly and effectively don the device in order for the functionality and performance to be realized. Moreover, patients must be encouraged to regular wear. Mechanically advantaged devices have been introduced to assist in a patient's ability to put on and wear an orthosis, with proper force delivered thereby. Strings and cords that serve to tighten these devices are tensively woven about pulleys or posts. The strings are typically connected to a plurality of pull tabs that a patient must pull bi-directionally away from the body, looped about his or her thumbs. These devices may be effective, but the tightening movement necessary may be outside the range of movement for at least some patients. Moreover, the narrow strings or cords may disadvantageously tangle, fray or jam, and at least some such devices require very particular positioning after patient doffing in order to allow for re-donning with functionality of the tightening system to be retained. And, the added weight and construction complexity of the pulleys or posts, generally installed inside enclosed pockets during manufacture, may impact comfort of wear and cost.
Cost of treatment is frequently an important consideration, first in the initial prescription and purchase, and thereafter during the course of the healing process. That is, over the treatment period, as a patient heals, the necessary level of support and control typically changes. In order to accommodate the changing needs, purchase of one or more additional orthoses may be disadvantageously necessary. Customization of posterior plates' lordosis and kyphosisspecifications, as well, may be disadvantageously prohibitive, wherein a patient is generally relegated to selection of closest general-fit options to his or her needs.
Therefore, it is readily apparent that there is a need for a spinal orthosis system, wherein a comfortable, supportive and cost-effective treatment is enabled, with custom-like fit, mechanically advantaged and easily adjustable force delivery, adaptability to patient healing and progression of needs, simplicity and durability of design, and ease and encouragement of patient use, thereby avoiding the above-discussed disadvantages.